Groans of Joy are the Joy of Pain
(A case study of one orphan, Musolima)
Encouraging outcomes
in OVC Programming
Presented by Moses Dombo
CCIH Conference May 25 2009
World Vision USA
Mdombo@worldvision.org
Some initial discussion provoking thoughts
• Due to High prevalence of HIV/AIDS in Sub-Saharan Africa,
the number of orphans and vulnerable children has continued
to increase
• It is important to recognize that before AIDS, there were OVC
and there will be OVC beyond HIV/AIDS.
• Responding to the growing need and needs of OVC is
becoming more complex:
– Number, scale, rate, longevity, new occurrences, distribution, gender
variations, location
– The food and economic crisis, urbanization and low land productivity
– Armed conflict and Domestic violence/ Child abuse issues
– There is need for more comprehensive, less disjointed, more inclusive, longer
lasting, family specific response models. How do you ensure better targeting?
– How do you ensure equitable service delivery?
Percent of children under age 15 that are orphans by
year, region and cause, 1990-2010
16
14
AIDS
12
Non-AIDS
10
8
6
4
2
0
19
90
19
95
20
01
20
05
20
10
19
90
Sub-Saharan Africa
Source: Children on the Brink, 2002
19
95
20
01
Asia
20
05
20
10
19
90
19
95
20
01
20
05
20
10
Latin America & Caribbean
Number of double orphans in sub-Saharan
Africa is increasing due to HIV/AIDS
8
AIDS
Non-AIDS
6
4
2
0
1990
1995
Source: Children on the Brink, 2002
2001
2005
2010
Who takes care of orphans? Relationship of double orphans
with head of household they live in
Ethiopia
Zimbabwe
Brother/
Sister
12%
Other
relative
24%
Grandparent
58%
Not related
0%
Adopted/
foster child
5%
Brother/
Sister
22%
Grandparent
20%
Other
relative
37%
Not related
9%
Adopted/
foster child
12%
Source: DHS, 1999-2001
Munimuthu
• The story of
Munimuthu – a
helpless child
• Sold to meet the
funeral expenses of
his mother
• Picked up on the local
media
Some initial discussion provoking thoughts
• CBOs and FBOs are striving in their own way to support Orphaned
and Vulnerable Children but with limited resources and
transparency challenges, there is need to identify more effective
service delivery models.
– Cash transfers, Service coupons, Chief’s granaries, UPE,
• There is need to identify the survival networks preferred by the
children (or established by their parents) and strengthen those
networks. families have access to comprehensive services.
• Families, Households, the ‘Extended family’ and the immediate
Communities in which these children live are the primary providers
of support to the children.
• If OVC programs will succeed, we need to learn how to build on the
efforts of these households, families (narrower and wider)
Family Based OVC model
• Makes children the centre of focus, but works
with the Caregivers/ Guardians to determine
most appropriate responses
• Measures impact at the family level
• Works through existing survival, development
and safety networks
• Coordinated by a central body for enhanced
accountability
• Is comprehensive and multi-sectoral
Bringing Hope Changing Lives:
Munimuthu and family after WV
Intervention
Lessons from
Groans of Joy are the Joy of Pain
• The pain of losing parents takes a very long time to
heal. Every time something hurtful happens, it
reminds the children of the loss of their parents.
• Parental loss is very disruptive to a child’s growth,
development, dreams and hopes for the future:
• But most development programs focus more on their
survival needs
• Even Psychosocial support projects tend to ignore the
socialization component.
Lessons from
Groans of Joy Are the Joy of Pain
• Extended Family jealousies/ conflicts can undermine service
delivery, therefore children should be given an opportunity to
choose their caregivers. Programmers need to take time
understanding the sociology of households, communities
before intervening. (Unfortunately, this basic social
development principle is undermined by current programming
models that rush for numbers and quick development gains
• Children never lose hope for a better future. They recognize
when they have been taken advantage of; but are constantly
looking for a helping hand that will help them to get to their
destination.
Lessons from
Groans of Joy Are the Joy of Pain
• Every little helps: It is not necessarily the big programs that
make the difference. For the individual child, it is that which
meets them at their point of need that counts.
• Education is the best investment in the lives of OVC
• Some outcomes are difficult to measure; but the impact of
good programming goes beyond individual children to cover
entire households.
Community Ownership, Resources and Sustainability
Natural Disaster, Political Instability, etc.
Less Empowered
Community has
little to no
resources to
provide for the
most immediate
needs but relies
completely on
WV.
Active and On-going Planning
World Vision Involvement
More Empowered
Community has
ability to match
the delivery and
provision of
services to meet
immediate needs
but still relies on
WV resources
while building
their own
capacity,.
Community is
able and willing
to provide
resources to
respond to
critical needs.
Supplemental
assistance by WV
is not needed.
Case Study of Joseph Kabogoza
`
In 1990, World Vision received a grant from World Bank through the government of Uganda to implement a poverty alleviation and vulnerable
population support program in Rakai district in Uganda. With that support, WV worked with the communities to get thousands of children who
had fallen out of school, back to the classroom by engaging a multi-pronged strategy: First World Vision paid School fees for thousands of
children, some of whom had fallen out of school after their parents fell sick and died, mostly to AIDS. Rakai at the time was the community worst
hit by the HIV and AIDS pandemic globally. Despondence and lack of Hope were rife. The registration of children in some schools had fallen by
more than 50%!
In some cases children had fallen out of school for paltry sums of money (300 shillings or 20 cents!) By getting children back in school, World
Vision was able to utilize that effort to advocate for retention of children in school and for greater accountability in schools, while working with
communities to improve or create infrastructure (building schools and teachers’ houses). World Vision also worked with the parents and guardians
of the children to improve household incomes and food security. When World Vision went to Rakai in 1990, the district used to be among the last
in the annual Primary leaving examinations. Since then, with additional support from other donors like DANIDA and the government, the
academic performance of Rakai is consistently among the top 20 districts in the country. The civil society is vibrant and evidently, WV has left a
mark on the community and thousands of children’s livelihoods have been transformed for the better.
In an evaluation conducted by World Bank, one grandparent told the evaluation team “World Vision can now go and help other people; because I
have been empowered enough”. Joseph Kabogoza had first approached WV when his grandchildren failed to pay Shillings 1,200 as examination
fees after World Vision had made a contribution of about Sh.4,000 in Tuition. World Vision helped him with his immediate need, but went ahead
to support him start a bee keeping project and passion fruit production. World Vision also provided support for him to improve his house, as the
one in which they lived risked killing them all. By the end of two years of working with Joseph, his household income rose from near zero, to
approximately Shillings. 120,000 per year from fruit and honey production. World Vision US believes that this is how empowerment works.
Rather than create a false dichotomy between Service delivery and Empowerment; ADP staff should be supported to learn how to prioritize
development needs with communities and how to package development responses for maximum benefit.